Exposure to HIV and hepatitis: Insulin pen

NEW YORK – A hospital on Long Island says only about 200 people have signed up for free blood tests, after it warned 4,247 patients about potential exposure to HIV and hepatitis.

South Nassau Communities Hospital sent out letters to patients who received insulin, due to possible blood contamination related to the use of an insulin pen.

Hospital officials say they are working with the health department and that the risk of infection is low, but insulin recipients may have received it from an insulin pen reservoir that could have been used with more than one person.

“Insulin pens are injector devices with a built-in insulin reservoir designed to be used multiple times, but for one person,” Eyewitness News Dr. Sapna Parikh said. “Insulin pens should never be used in more than one person because with each injection, there’s a small risk a small amount of blood can go backwards into the cartridge, creating a risk the next time.”

The hospital released a statement saying, “South Nassau has already implemented a hospital-wide policy that bans the use of insulin pens and permits only the use of single-patient-use vials to administer prescribed insulin treatments to patients.”

The full statement released by the hospital: “Working closely with the New York State Department of Health, South Nassau is voluntarily notifying a specific group of patients that may have received insulin from an insulin pen reservoir (not the pen’s single-use disposable needle) that may have been used with more than one patient. The risk of infection from this is extremely low, nonetheless, out of an abundance of caution, the hospital is recommending that patients receiving the notification be tested for hepatitis B, hepatitis C and HIV. While the testing is voluntary, it is recommended. To facilitate the process, the hospital is offering the patients free and confidential blood testing services. It has established a dedicated toll-free telephone number that the patients may call to schedule a blood test within 60 days after receiving the letter. South Nassau has already implemented a hospital-wide policy that bans the use of insulin pens and permits only the use of single-patient-use vials to administer prescribed insulin treatments to patients.”

Visit ABC News for the story.

SafMed Introduces a Documentation System to Track, Record and Verify Medical Device Decontamination (Cleaning)

The current SafMed Tracking and Documentation system allows the CSSD and Theatre to trace and record the link between items used on patients and theirsterilization process.

SafMed is introducing an additional, complementary system to trace the link between medical devices used on patients and their cleaning process.

This system allows users to create a label containing vital reprocessing information. The label is affixed to the instrument check list. The check list is then placed inside the cleaned set ready for packaging. (Alternatively the label can be applied to the packing of a single packed instrument). The label is linked to the proof that the instrument washer was working correctly, or linked to information regarding the manual cleaning of that device (who cleaned it and when).

The label is removed from the instrument check list only when the sterile set/pack is opened and used on a patient. The label is then affixed to the patient’s perioperative document, linking the patient to the recorded cleaning process.

This additional label is attached next to the sterilization label in the perioperative document, facilitating a more detailed tracking system.

The system consists of the following items:

Labelling gun:

The labelling “gun”, with duplex tracking labels, enables the user to adjust the dial on the gun in order capture/document the date on which the medical device was cleaned, who the operator was, which washer and which cycle of the day it was. This information is applied via the duplex tracking label onto the instrument set check list.

Tracking labels:

The duplex tracking label is pre-printed with the term: DECONTAMINATED.

STF Load Check:

This device is designed to test the cleaning efficacy of the washer disinfector in accordance with ISO 15883 part 5. The STF load check is recommended to be used when medical devices are cleaned in an instrument washer.

Archive Envelopes:

This enables the user to archive all relevant data related to the performance of the instrument washer

This is an easy to understand, simple to implement, complementary system to enhance your ability to provide evidence of device decontamination.

SHEA Issues New Guidance on Healthcare Personnel Attire to Limit HAI Transmission

Healthcare personnel engaged in direct patient care in non-operating room settings should possess two or more white coats and have access to a convenient and economical means to launder them no less frequently than once a week or when visibly soiled, states new guidance on healthcare personnel attire from the Society for Healthcare Epidemiology of America (SHEA) published in the February 2014 issue of Infection Control and Hospital Epidemiology.

According to SHEA, there is limited data on the optimal approach to healthcare personnel attire in clinical, nonsurgical areas, and until appropriately designed studies can be funded and performed to better define the relationship between attire and healthcare-associated infections (HAIs), priority should be placed on evidence-based measures to prevent HAIs and attire choices should attempt to balance professional appearance, comfort, and practicality with the potential role of apparel in the cross-transmission of pathogens resulting in HAIs. In addition to possessing multiple white coats and laundering them more frequently, SHEA recommends that white coats always be washed in a hot-water cycle with bleach, followed by a cycle in the dryer.

SHEA also recommends that personnel remove their white coat (or other long-sleeved outerwear) and place it on a hook prior to any contact with patients or the patient’s immediate environment. Another recommendation in the guidance is that facilities adopt a “bare-below-the-elbows” approach, which involves wearing only short sleeves, no wristwatch, no jewellery, and no ties during clinical practice. SHEA notes that while the incremental infection prevention impact of this approach to inpatient care is unknown, the practice is supported by biological plausibility and studies in laboratory and clinical settings.

Other recommendations in the guidance include that all footwear have closed toes, low heels, and non-skid soles; that name tags or identification badges be clearly visible on all attire for identification purposes; and that shared equipment, including stethoscopes, should always be cleaned between use on patients. SHEA concludes that no guidance can be offered in general regarding prohibiting items such as lanyards, identification tags and sleeves, cell phones, pagers, and jewellery, but those items that come into direct contact with the patient or environment should be disinfected, replaced, or eliminated.

Additional coverage of the guidance is provided by a January 20, 2014, NBC News article